血清鸢尾素及摄食抑制因子在中枢性性早熟女童诊断中的意义OACSTPCD
Diagnostic significance of serum irisin and nesfatin-1 in girls with central precocious puberty
目的 探讨女童中枢性性早熟(central precocious puberty,CPP)血清鸢尾素(irisin)、摄食抑制因子(nesfatin-1)表达水平及临床诊断价值.方法 选取自2018年1月至2022年1月唐山市妇幼保健院诊治的CPP女童74例为CPP组,以同期确诊的单纯性乳房早发育(premature thelarche,PT)的女童60例为PT组.酶联免疫吸附实验检测血清irisin、nesfatin-1水平.Pearson相关分析血清irisin、nesfatin-1水平与CPP患儿临床资料的相关性.多因素logistic回归分析影响CPP发生的因素.受试者工作特征(ROC)曲线分析血清irisin、nesfatin-1对CPP的诊断价值.结果 CPP组血清irisin、nesfatin-1、体质指数(BMI)标准差评分、超前骨龄、黄体生成素(LH)基础值、卵泡刺激素(FSH)基础值、LH/FSH基础值比值、雌二醇、卵巢体积、子宫体积均大于PT组,差异具有统计学意义(均P＜0.05).CPP组血清irisin、nesfatin-1与BMI标准差评分、超前骨龄、黄体生成素基础值、卵泡刺激素基础值、黄体生成素/卵泡刺激素基础值比值、雌二醇、卵巢体积、子宫体积呈明显正相关(均P＜0.05).血清irisin、nesfatin-1是影响CPP发生的独立危险因素.血清iri-sin、nesfatin-1联合的曲线下面积为0.927(0.891～0.959),大于单项指标检测0.839(0.799～0.857)、0.812(0.781～0.842),差异具有统计学意义(Z=5.183、4.949,均 P＜0.001).结论 女童 CPP 血清 irisin、nesfa-tin-1 水平升高,两者与CPP女童性激素水平有关,两项联合对CPP的诊断具有较高的临床价值.
Objective To investigate the expression levels of serum irisin and nesfatin-1 and their clinical diag-nostic value in girls with central precocious puberty(CPP).Methods A total of 74 girls diagnosed with CPP from Janu-ary 2018 to January 2022 at Tangshan Maternal and Child health Care Hospital were included in the CPP group.Sixty girls with isolated premature thelarche(PT)during the same period served as the PT group.Serum levels of irisin and nesfatin-1 were measured using enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was used to examine the relationship between serum irisin,nesfatin-1 levels,and clinical data of CPP patients.Multivariate logistic regression was employed to identify factors influencing the occurrence of CPP.Receiver operating characteristic(ROC)curve analy-sis was conducted to assess the diagnostic value of serum irisin and nesfatin-1 for CPP.Results The levels of serum iri-sin,nesfatin-1,body mass index(BMI)standard deviation scores,advanced bone age,basal luteinizing hormone(LH),basal follicle-stimulating hormone(FSH),basal LH/FSH ratio,estradiol 2,ovarian volume,and uterine vol-ume were significantly higher in the CPP group than in the PT group(all P＜0.05).There were significant positive corre-lations between serum irisin,nesfatin-1,and BMI standard deviation scores,advanced bone age,basal LH,basal FSH,basal LH/FSH ratio,estradiol,ovarian volume,and uterine volume in the CPP group(all P＜0.05).Serum irisin and nesfatin-1 were identified as independent risk factors for CPP.The area under the ROC curve(AUC)for the combined detection of serum irisin and nesfatin-1 was 0.927(95％CI:0.891-0.959),which was significantly greater than that for each marker alone[0.839(95％CI:0.799-0.857)for irisin,0.812(95％CI:0.781-0.842)for nesfatin-1](Z=5.183,4.949,both P＜0.001).Conclusion Elevated levels of serum irisin and nesfatin-1 are observed in girls with CPP,and these levels are associated with hormone levels in CPP girls.The combination of serum irisin and nesfatin-1 offers a higher clinical diagnostic value for CPP than either marker alone.
焦娇;张雪松;郑新月
唐山市妇幼保健院儿童保健科(河北唐山 063001)唐山市妇幼保健院小儿内分泌科(河北唐山 063001)
临床医学
中枢性性早熟鸢尾素摄食抑制因子诊断女童
central precocious pubertyiridinnesfatin-1diagnosisgirls
《广东医学》 2024 (009)
1101-1105 / 5
河北省医学科学研究课题计划(20231770)
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